Post ablation

[Bauldy]

I am waiting to go for a ablation, am I correct in thinking before I have the procedure and will I be have to be on blood thinners ? I am just trying to get some time scale to this.i have not seen a ep yet

[CDreamer]

Yes that is correct, although anticoagulants don't thin the blood - they prevent clots from forming which increases the danger of stroke for us AFers. The risk increases after return to NSR and most strokes occur between 24 hours and 3 weeks after AF episode. Therefor if you are having ablation it is essential that the team know you are not nesting a clot in you atria appendage, which is where they tend to hide.

Time scale will depend on whether or not you are on Wafarin or NOAC - the former you will need to wait until you have a stable INR of between 2-3. For some people this is easy but you need at least 4 weeks of stablity. NOACS work differently therefore the time scale will be less - I had ablation 2 weeks after starting on NOAC.

It will also depend on your team as EPs do tend to have slightly different opinions and methods. Have you asked?

Best wishes CD

[BobD Volunteer]

Yes to anticoagulation and to remain on them for a few months afterwards. It depends a lot on your EP as there appears to be no gold standard here. I was on warfarin for three months before ablation but as CD suggests this could be much reduced with one of the new oral anticoagulants. Since the waiting list for ablation in UK is generally about six months (more in some areas) this will not be a problem as there is plenty of time to get sorted in that respect.

Good to understand where you are of course but horse before cart and see that EP first who will explain his requirements.

[PeterWh]

Yes.

If it is to be warfarin (some insist on this) then realistically make sure you start 2 months beforehand. Typically people can take 2 weeks (+ or - 1 week) to get in range and then 4 results in range. I decided to switch to warfarin 3 months before but still could not get in range for the four tests previous. Also double check the range. Clinics automatically assume 2.0 to 3.0 whereas for many ablations (mainly if persistent) EPs require 2.5 to 3.5 because of doing a DCCV at the end.

If going on one of the NOACs then typically 4 weeks beforehand.

[davegm]

Not necessarily - at least I wasn't - so I guess it depends on the specific patient and proceedure

[seasider18 in reply to davegm]

I had a phone call offering me an ablation as they had a cancellation. I turned it down as I had stopped taking warfarin. The EP said that we can do it without. My GP expressed great surprise at that statement.

[davegm]

Sorry

Just re read your original post so for clarification...

I was not on anticoagulation before the ablation but was on Apixaban for 12 months after.

[Bauldy]

Thanks for the replies

I have been in af again since yesterday 5.30 ish until about 40 minutes ago , I have only just returned to work after 2 weeks after a particularly bad attack. If my af progressively when will I get sorted .... wait for ep appointment.... wait for blood thinners to work .... wait for ablation in between all that my only help is this site . So after reading the post and the thought of months waiting I phoned the hospital for some advice on my appointment, the booking department have a appointment for march to see my cardiologist but this is a follow up ... she put me on hold and after 10 minutes came back saying I would receive a phone call with a appointment date from the ep secretary .... maybe I had been over looked .

Thanks again

[Sarah57 in reply to Bauldy]

Hi

They sat me up, once I was on "the table" and already sedated , and just asked me to swallow an anti coagulant that apparently takes effect straight away, then took one a day post ablation for one month.(Riveroxaban) apologies if wrong spelling, but have to be off to work!) Nothing after that, and no beta blockers either! So good luck and hope it all goes well for you. Has changed my quality of life and feel so so much better and dare I say, no AF so far after 7months!

All the best

Sarah

[seasider18 in reply to Bauldy]

Or as I have twice been told 'Dropped off the Radar'